MEDICARE: IMAN AUBREY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor	NV
2	101YM0800X	Mental Health Counselor	NV
3	106H00000X	Marriage & Family Therapist	NV
4	324500000X	Substance Abuse Rehabilitation Facility	NV

General Provider Information

NPI Number	:	1578426144
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	IMAN AUBREY

Provider Business Mailing Address
First Line	:	3650 S EASTERN AVE STE 150D
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89169-3379
Country	:	US
Telephone Number	:	818-540-5373
Fax Number	:

Provider Business Practice Location Address
First Line	:	3650 S EASTERN AVE STE 150D
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89169-3379
Country	:	US
Telephone Number	:	818-540-5373
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/09/2025
Last Update Date	:	12/09/2025

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Directions to “ IMAN AUBREY ” Practice Location

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